CHARGES FOR NEWBORN SCREENING

Selected disorders

Sickle cell anemia: Red blood cells form an abnormal crescent shape and deliver less oxygen to the body’s tissues. People with this disease can die from organ failure and infection but can live into their 50s or longer. Number of confirmed cases in Missouri among newborns was 159 from 2005-2008 or 1 in 2,030 births. Cystic fibrosis: Defective gene causes the body to produce unusually thick mucus that can clog the lungs and lead to fatal lung infections. Forty-eight cases in Missouri newborns in 2007-2008 or 1 in 3,392 births. Fatty acid disorders: The body can’t break down fatty acids to make energy because an enzyme is missing or not working correctly. If undiagnosed, can lead to excessive fat buildup in the liver, heart and kidneys. Can be fatal. Forty-nine cases confirmed in newborns in Missouri from 2005-2008 or 1 in 6,586 births.

More

ADVERTISEMENT

Lucy Brown was in the typical throes of caring for a newborn, waking up around the clock to feed her daughter, when she got a bill for a state-mandated blood test on the infant.

She thought the bill from Mercy Hospital Springfield — $665 before insurance for drawing the blood and the tests — seemed high, so she started asking questions. What she found out is that the state lab that does the tests charges hospitals $65.

“I was flabbergasted at how much it was,” said Brown, an Ozark resident. “I think it’s ridiculous. The state charges $65, which even includes the postage.”

Sonya Kullmann, a spokeswoman for Mercy, said the hospital is reviewing the charge for the test to see if it should be changed. The standard fee at Mercy Hospital Springfield for the test is $629 — close to 10 times the charge by the state lab — which includes processing the blood, delivering it to the state lab, receiving the results and billing for the procedure.

“It (the fee) is currently under review at our facility,” Kullmann said. “Our ministry is constantly evaluating what we charge for thousands of different tests and procedures. Those charges often fluctuate, depending on our cost to provide our patients with the best care. When it’s appropriate, we reduce those costs as we move forward.”

CoxHealth charges $531, about eight times the fee the state lab charges. Freeman Health System in Joplin charges about $149, about double the state fee. Citizens Memorial Healthcare in Bolivar charges about $96, the cheapest among area hospitals contacted by the News-Leader.

Stacy Fender, a spokeswoman for CoxHealth, said the cost for CoxHealth is more than what the state lab charges.

“Staff time and resources are used to collect the test, process it, receive, handle and communicate the results, and much more,” she said.

Each year, the state lab tests blood samples from about 80,000 newborns and does 10,000 re-tests, according to the state Department of Health and Senior Services. The state lab fee is set by state regulation, but hospitals can set what fees they decide are warranted to cover the procedure.

(Page 2 of 2)

“We don’t have any control over what the hospital or birthing center can charge,” said Gena Terlizzi, a spokeswoman for the Missouri Department of Health and Senior Services.

Gordon Kinne, the president and owner of Med-Pay Inc., said there is often no transparency in medical bills.

“Welcome to my world,” he said. “It’s just nuts. They charge whatever they can.”

Med-Pay processes medical claims for employers such as Missouri State University, where Brown’s husband, David Romano, is an associate professor teaching Middle Eastern politics. MSU is self-insured.

The family had to pay for the test twice because Hannah, now 5 months old, initially tested positive for cystic fibrosis. In both cases, the family had to foot most of the bill after standard deductions negotiated for insurance.

The $665 bill for the second test was reduced by a standard discount of about $200. Mercy reduced the second bill by an additional $150 after Brown complained.

Brown said she paid the bill because she didn’t want to be reported to a credit agency but continued appealing to the hospital.

“Are they recognizing that they were overcharging in the past and are they going to refund the money to their customers?” she asked.

Newborn screening began about five decades ago with testing for PKU, a hereditary condition which a baby is born without the ability to properly break down an amino acid called phenylalanine. The condition can lead to mental disabilities but is treatable. Missouri mandates screening for 67 diseases such as cystic fibrosis and sickle cell anemia.